Three-step strategy for the prevention of surgical blood clots

The National Institute for Health and Clinical Excellence has published guidelines to tackle the problem of potentially life-threatening venous thromboembolism (VTE) in patients who have undergone surgery.

The guideline, produced for NICE by the National Collaborating Centre for Acute Care (NCC-AC), is the most comprehensive review and analysis of evidence so far.

A three-step strategy for prevention has been proposed.

  • Most people should be offered compression stockings to wear whilst in hospital. For many patients the use of inflatable 'boots' during the operation will also be beneficial.
  • Blood thinning medication, such as low molecular weight heparin or fondaparinux, should be given to all people having orthopaedic surgery and to other surgical patients who are at high risk of developing VTE. This medication should be continued for four weeks if the surgery was for a broken hip.
  • In some patients, regional anaesthesia rather than general anaesthesia should be considered.

The guidance is available on the NICE website.

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